Getting the NHS back on its feet

Following on from our ‘Transforming health services: Our response to government priorities’ blog, Unity Insights aim to highlight current experiences in supporting quality improvement in the NHS. In particular, how evaluation and analytical experience can help support organisations in making the right changes to meet demands.

One of the biggest challenges facing commissioners is managing the variation in population needs and geographical factors that can make a significant difference in realising the benefits of new innovations and services. Deciding which systems or service models will really make things easier for the workforce and maximise capacity, whilst working with a limited budget is never going to be an easy journey, and it would be a surprise to no-one that it must be an iterative process.

Co-design is one of the most important tools when introducing change to a system. Understanding the specific barriers and requirements that can make service transformations a success requires the input and expertise of staff at all levels. This can be a difficult process to facilitate when under pressure, but listening to voices at all levels of an organisation may well highlight easy wins, inform PDSA cycles, and provide invaluable feedback to industry partners looking to develop robust and market-ready interventions.

A wide variety of approaches exist to support this process, one of the most beneficial is to undertake a logic modelling workshop at the outset of a project. Identifying the key impact that you hope to deliver, identifying barriers and enablers, the activities needed, and the evidence that could be collected to show how effective the intervention has been once introduced. This process can often help a project get ahead in both directly incorporating feedback from a broad group of stakeholders, as well as establishing baseline data that can be used to compare improvement against. It can also provide a great opportunity to discuss risk mitigation strategies and potential system impacts, which is also an often-overlooked step in change management.

Systems thinking is a great approach to help model the impact of changes upon complex systems, supporting insights into the impact upon the patient population and the wider healthcare infrastructure. At Unity Insights we have utilised system dynamics to help model transformation programmes and highlight downstream impacts of localised change, how they may affect relationships between primary and secondary care, waiting lists or patterns of patient flow on a regional level.

Each commissioning body will have a unique perspective in terms of demand and organisational priorities, as well as different bases for funding arrangements. The intersections and relationships across organisations and pathways must be a key consideration to help foster ongoing improvement across the NHS.

This is something we will be covering in our first of series of short workshops on 4th September, ‘Getting the NHS back on its feet’, sharing our experiences and discussing the range of evaluation techniques available to support informed decision making.